These are important research topics for me because I already have joint pain and depression and so when I consider getting castrated, I am concerned about exacerbating these symptoms.

I’m especially interested in how castrated people with joint pain manage their pain when their sex hormones diminish, assuming they are not taking a full dose of replace hormones or anything like that.

The depression stuff is personal, I might actually be happier as a eunuch. In any case, I think that extensive journaling is the best way to manage depression in general.

Conrad73 (imported) wrote: Wed Jan 24, 2024 8:53 am These are important research topics for me because I already have joint pain and depression and so when I consider getting castrated, I am concerned about exacerbating these symptoms.

I’m especially interested in how castrated people with joint pain manage their pain when their sex hormones diminish, assuming they are not taking a full dose of replace hormones or anything like that.

The depression stuff is personal, I might actually be happier as a eunuch. In any case, I think that extensive journaling is the best way to manage depression in general.

Depression is a definitely recognized risk as a side effect of getting castrated, with the usual suggestions for treating such as counseling / therapy, medications, and so on. However it is worth noting that a lot of the data claiming depression as a risk is coming from those getting castrated involuntarily due to either accidents or (more often) medical reasons such as prostate or testicular cancer, so there has been some speculation that the depression is more due to the circumstances than the actual surgery... In addition folks getting M->F transition surgery, which normally includes castration, don't seem to have the same incidence of depression. However TG surgery is also done in combination with a lot of hormone replacement, while those getting fixed due to prostate cancer (chemically or surgically) don't get hormones because they are part of the patient's problem...

Here I have seen some members reporting depression after surgery, and getting relief by starting on some level of hormone replacement, either testosterone or estrogen.

Because I'm already at high risk of bone health issues because of my SCI, my docs insisted that I go on some form of hormones and promise to stay on them as a condition for them agreeing to my surgery... Since I felt that testosterone just fed my frustration about my SCI induced sexual inability, I opted to go with estrogen - and I'm mostly happy with that choice... I use an estradiol patch in a dose that my doc says is the average level for a pre-menopausal woman (a woman has very wide swings during her cycle) and she feels that is the minimum that I should be at to minimize my bone health issues. I have gotten some breast growth, which I'm not happy about, but is not quite enough to push me outside the 'normal male' appearance range when dressed so not a big deal.

Just out of curiosity, have you ever had your testosterone levels checked to see where you fall currently?

In terms of joint pain, I have not heard of that being a major problem, the big concern is loss of bone strength due to osteoporosis which is more a problem with the bones, not the joints. Personally I have a fair amount of problems with osteoarthritis, mostly in my hands, which I'm told is mostly because of the cumulative wear and tear of using them a lot all my life, plus the added abuse they get from all the transfers and such that you have to do when paralyzed, not because of hormone issues... I can't say that I've noticed much change in things since I started on this path. (Before I did, I had low T, and had been on supplemental T to get me back into 'normal' range for several years)

A lot of people, as well as the WPATH SOC suggest a trial period of chemical castration before considering surgery, as a 'test drive' to somewhat see what being a eunuch feels like, and if one likes it... The advantage is that chemical castration is reversible if not done for to long. The downside is that you mostly just get the effect of being low T, but the balls are still there... From what you describe about your condition, it (probably) would not help with the pain issues, but it's the closest thing you will get...

A minor data point when talking about chemical castration meds, is that Androcur, which is popular in the rest of the world, is not FDA approved in the US, so isn't available, however there are other drugs which will do the job as well or better, and without some of the other unpleasant side effects of Androcur... They used Lupron on me, which is much more expensive (covered by my insurance so not a big concern) but worked quite well at dropping me to castrate T levels in under a month, w/o a lot of nasty side effects....

WheelyFixed

Thanks for the information. The short answer to your question is I don’t have any current hard evidence regarding my hormone levels. it would be good to know..

The longer answer is: about 18 months after my injury I went to an endocrinologist thinking I had low T and he said your levels were within the normal range (for a 14 year old, at that time).

I would guess, based on the level of secondary sex characteristics that I’ve developed and how I feel most days, that my T is somewhere near the lower end of normal, and may be clinically low at times. It seems low especially to me because the guys in my family are mostly ultra masculine, hung, athletic, competitive etc. I’m none of those, I have regular erections but not orgasms (which are usually painful), I have a soft androgynous appearance overall, I used to be mistaken as a girl regularly until I grew a beard. I started wearing loose clothes to hide my curves too. It’s not too uncommon for women to hit on me, because I’m able to pull off this “soft masculinity” that is in style, but I’m really picky about women and don’t want to be a cuckold, although I’m really submissive.

I can’t emphasize how much I’m not in a hurry to get castrated. I’m about to turn 30 and it looks like I have some serious testicular problems and that the procedure would relieve some gender related anxiety, so I’m looking into it but I doubt I would do it before I turn 40, unless the testicles take a turn for the worst before then. Maybe 35 at the soonest.

The last thing is… I have a lot of joint pain, some from chronic injuries (extreme sports), some from weak tendons etc, and it is aggravated by manual labor among other things, and I think that testosterone really keeps the inflammation down, when my perceived “T” or “manliness” are low, joint pain goes up, and vice versa.

Conrad73 (imported) wrote: Wed Jan 24, 2024 7:16 pm Thanks for the information. The short answer to your question is I don’t have any current hard evidence regarding my hormone levels. it would be good to know..

The longer answer is: about 18 months after my injury I went to an endocrinologist thinking I had low T and he said your levels were within the normal range (for a 14 year old, at that time).

I would guess, based on the level of secondary sex characteristics that I’ve developed and how I feel most days, that my T is somewhere near the lower end of normal, and may be clinically low at times. It seems low especially to me because the guys in my family are mostly ultra masculine, hung, athletic, competitive etc. I’m none of those, I have regular erections but not orgasms (which are usually painful), I have a soft androgynous appearance overall, I used to be mistaken as a girl regularly until I grew a beard. I started wearing loose clothes to hide my curves too. It’s not too uncommon for women to hit on me, because I’m able to pull off this “soft masculinity” that is in style, but I’m really picky about women and don’t want to be a cuckold, although I’m really submissive.

I can’t emphasize how much I’m not in a hurry to get castrated. I’m about to turn 30 and it looks like I have some serious testicular problems and that the procedure would relieve some gender related anxiety, so I’m looking into it but I doubt I would do it before I turn 40, unless the testicles take a turn for the worst before then. Maybe 35 at the soonest.

The last thing is… I have a lot of joint pain, some from chronic injuries (extreme sports), some from weak tendons etc, and it is aggravated by manual labor among other things, and I think that testosterone really keeps the inflammation down, when my perceived “T” or “manliness” are low, joint pain goes up, and vice versa.

I would definitely say that finding out what your current T level is should be a pretty high priority, along w/ more in depth testing on your testicles - given that you have pain and at least some symptoms of low T, it should be easy to get a doctor to order those. It seems to me that you can't really figure out where you should be heading if you don't know where you are... If I understand the history correctly, you got hurt as an early teen or pre-teen, so a lot of years have passed since then, and things may well have changed considerably.

Just out of curiosity, I did a quick Startpage search on "tendon testosterone" - came back with a lot of results, which on a cursory examination suggested that hormone imbalances can cause tendon problems, but that Testosterone may not be the best thing for it... Its an interesting question for sure... Again it seems like a more definitive diagnosis as to what is going on seems like a good idea, there can also be genetic causes for joint and tendon issues, as well as other causes and having a better idea about why you are having the issues may well give you more useful ways to solve them or at least avoid aggravating them....

I also certainly don't want to give the impression that I or anyone else is trying to rush a decision, or push you in the direction of getting fixed... Castration is a MAJOR life changing decision, and we certainly don't want to see anyone rushing into it without a lot of careful consideration... Chemical castration can be a useful experiment specifically because it can be reversed, but unless you are absolutely certain it is best to avoid anything that isn't reversible.... The folks here are generally happy with their results, which tends to make us come across as enthusiastically in favor, but mostly we want to help provide the information and support you need to make your own decision, and we will support you whatever you decide... Bottom line is that if you have ANY doubts, DON'T!

I certainly can understand how you may not be thrilled about medical care and the stuff doctors put people through, but from all you've said here and in other threads it sounds to me like you really would benefit from a really thorough medical evaluation and diagnostics to find out what is really going on and let you make better decisions about what you should do going forwards.

From your other thread it also sounds like trying to get a referral to a therapist experienced in helping folks sort out their gender issues may be of great benefit - yet another reason to be talking with your local TG center, since they will almost certainly have a good idea about who to have you work with....

WheelyFixed

WheelyFixed wrote: Wed Jan 24, 2024 3:11 pm Here I have seen some members reporting depression after surgery, and getting relief by starting on some level of hormone replacement, either testosterone or estrogen.

Because I'm already at high risk of bone health issues because of my SCI, my docs insisted that I go on some form of hormones and promise to stay on them as a condition for them agreeing to my surgery... Since I felt that testosterone just fed my frustration about my SCI induced sexual inability, I opted to go with estrogen - and I'm mostly happy with that choice... I use an estradiol patch in a dose that my doc says is the average level for a pre-menopausal woman (a woman has very wide swings during her cycle) and she feels that is the minimum that I should be at to minimize my bone health issues. I have gotten some breast growth, which I'm not happy about, but is not quite enough to push me outside the 'normal male' appearance range when dressed so not a big deal.

WheelyFixed

Is the gynecomastia a new thing for you? Or is it just increasing? How do you feel about it?

As for me… I have stage 2 gynecomastia (rounded, soft, breast tissue spread out but still small) and am very used to it, what gives me anxiety is when people stare.

I would probably start needing a bra if I took estrogen, otherwise it sounds like it would be nice to try.

WheelyFixed wrote: Wed Jan 24, 2024 3:11 pm I have gotten some breast growth, which I'm not happy about, but is not quite enough to push me outside the 'normal male' appearance r

Conrad73 (imported) wrote: Thu Jan 25, 2024 4:26 am ange when dressed so not a big deal.

WheelyFixed

Is the gynecomastia a new thing for you? Or is it just increasing? How do you feel about it?

As for me… I have stage 2 gynecomastia (rounded, soft, breast tissue spread out but still small) and am very used to it, what gives me anxiety is when people stare.

I would probably start needing a bra if I took estrogen, o

therwise it sounds like it would be nice to try.

The growth is new since I started on E, but essentially was a short term thing of a few months, and has now been stable for quite a while... I had a lot of nipple / breast bud sensitivity while it was happening, but that has mostly gone away now (which is a sign that growth has stopped). I'm still more sensitive than I was, and can now feel a definite bud structure under the nipples (like my GF's) which used to be almost undetectable. My nipples also stick out more most of the time. Size-wise, I now have enough to fail the 'pencil test' and feel like they are very obvious when naked, but when I put on even a t-shirt they become less obvious though still visible... It probably helps that I have more of a belly than I would like, so they sort of 'blend'... This is just based on what I see in the mirror, but I have not gotten any comments, or noticed any stares... Basically I'd say that I'm on the big breasted side of the 'normal male' range, but still within it... I don't wear any sort of bra, and don't feel a need to.

Basically the pattern for most when going on E is to get growth over the next 6 months or so, which then stops as they are 'fully grown'. How much is relatively unpredictable, but tends to be less when older, and also somewhat matches what your female blood relatives have.... Essentially your body is doing a sort of equivalent to female puberty, but not quite.... Given that you already have gyenecomastia, how much more growth you'd get is something I have no idea about, but might be something an endocrinologist w/ TG experience might be able to answer better... There is also a class of drugs known as SERM's (Selective Estrogen Receptor Modulator) that do the same sorts of things as estrogen does, EXCEPT for growing boobs... They normally use these for women w/ certain estrogen sensitive cancers to give them the bone and mental health benefits w/o aggravating the cancers. Downside is they have a higher risk of blood clots than estradiol, and because I spend all my time sitting around which increases my clot risk, the doc felt they weren't a good choice for me.

WheelyFixed

Interesting bit about the pencil test. I don’t need a bra according to that test, but I wear a sports bra for some activities, it prevents jiggling and actually makes my boobs less noticeable under a sweat shirt. What calms my anxiety is the fact that most men seem to have boobs these days, so I don’t really stand out.

I ordered an inexpensive saliva sample testosterone test kit, and tried contacting both primary care physicians and the local transgender center and they are all way booked out for the time being. I might be able to see someone late this year or next year. My finances and healthcare plan will limit what treatment routes are available. I’ll try jumping through some of their hoops. In the meantime I will be in a lot of pain and tinkering around with various herbal and nutritional remedies…

Conrad73 (imported) wrote: Fri Jan 26, 2024 1:17 pm I ordered an inexpensive saliva sample testosterone test kit, and tried contacting both primary care physicians and the local transgender center and they are all way booked out for the time being. I might be able to see someone late this year or next year. My finances and healthcare plan will limit what treatment routes are available. I’ll try jumping through some of their hoops. In the meantime I will be in a lot of pain and tinkering around with various herbal and nutritional remedies…

Sounds reasonable, and as long as you are careful about the herbs, etc. it is unlikely to make things worse... Keep in contact w/ the TG center, and ask to get on their "cancellation list" as that may get you in sooner... It may also be worth asking if they can give you a list of the therapists they work with and try getting in to one of those while still waiting... The SOC has a requirement for getting letters of approval from at least one therapist (My insurance required two letters, which was the older versions requirement) so you may find doing that will get you ahead of the game...

WheelyFixed

I am pretty careful with the herbs, aware of some of the dangers. I just stay low dosage and not complex combinations. Vitex wasn’t working like it used to, but now black cocosh seems to help (marginally) with mood and arthritic pain. The really nice thing that I just found out is I’m probably going to be able to fund several blood tests this year, even before seeing a doc. I’m going to put off working with a therapist for a while but I get your point. I’m thinking I may prefer a unilateral orchiectomy, if the uncrushed one is in good shape and can produce enough T.